Provider Demographics
NPI:1720600042
Name:LUMANA LTD. CO
Entity Type:Organization
Organization Name:LUMANA LTD. CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FIONDA
Authorized Official - Middle Name:WILLIAMS
Authorized Official - Last Name:BROCK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:702-329-0799
Mailing Address - Street 1:1001 S MAIN ST STE 5125
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-5635
Mailing Address - Country:US
Mailing Address - Phone:702-329-0799
Mailing Address - Fax:
Practice Address - Street 1:221 E INDIANOLA AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2002
Practice Address - Country:US
Practice Address - Phone:702-329-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-08
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing CareGroup - Multi-Specialty